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Urine cortisol

Cortisol is the major glucocorticoid hormone synthesised from cholesterol in the adrenal cortex. Synthesis is stimulated by the anterior pituitary adrenocorticotrophic hormone (ACTH), which is under control of the hypothalamic peptide, corticotrophin-releasing hormone (CRH). 

As cortisol concentrations increase, the binding capacity of cortisol binding globulin in the circulation is exceeded, resulting in a disproportionate rise in urine cortisol concentrations. Urine cortisol measurement is useful as a screening test for cortisol excess (Cushing’s syndrome). Urine cortisol measurement can also be used as part of a dexamethasone suppression test. Multiple EMU cortisol measurements may also be useful in the investigation of possible cyclical Cushing's.

Sample Requirements and Reference Ranges

Sample type  Urine (24 hr, random or early morning urine)
Container  Plain urine container (no preservative)
Precautions  None
Minimum volume  10 mL
Reference range  Adults (EMU): <40 nmol/mmol creatinine

 Adults (24 hour): <165 nmol/24 hour

 Children (≤10 yrs): <40 nmol/mmol creatinine
Turnaround time  14 days
Method  Liquid chromatography-tandem mass spectrometry
 
Quality Assurance
UK NEQAS